Behavioral Economic Supplement to Motivational Interventions

This brief, supplemental program is designed to reduce heavy drinking in college students by increasing focus on academic/career goals and participation in substance-free activities. The behavioral economic component supplements existing motivational interventions with this population. An experimental evaluation found that this program had a significant impact on the reduction of alcohol-related problems compared with students in the control group who received a brief motivational interview alone. For those with depression symptoms and low levels of substance-free activity reinforcement, this program had a significant impact on the reduction of heavy drinking.

DESCRIPTION OF PROGRAM

Target Population: College students who engage in heavy drinking.

This program is designed to supplement brief motivational interventions with a behavioral economic component to decrease heavy alcohol use, and the associated outcomes, in college students. Behavioral economic research focuses on how patterns of substance use develop and change in relation to the costs and benefits of substance use compared to other activities. The program is delivered in a single session. The behavioral economic supplement is a 50-minute Substance-Free Activity Session (SFAS) designed to increase the perceived value of academic and career goals, highlight the association between substance use and goal accomplishment, and increase engagement in substance-free activities. The SFAS utilizes a motivational interviewing approach with additional personalized feedback. This program is a single-session intervention designed to be delivered by clinicians to individuals who are not necessarily motivated to obtain long-term treatment. Students in the control group received the single brief motivational interview session with a second relaxation session.

Evaluated Population: This sample consisted of 82 freshman college students at a public university in the southern United States who were identified as heavy drinkers (≥ 5/4 drinks on one occasion two or more times in the past month for a male/female) on a screening survey. The average age was 18.5 years, and the sample was 50 percent female. A total of 82 percent self-identified as white, 12 percent as Black/African-American, 2 percent as Hispanic, 1 percent as Asian, and 1 percent as Native American.

Approach: Students were recruited from university-wide introductory classes, and were eligible to participate if they were 18 to 21 years of age, full-time freshman, and worked fewer than 20 hours per week. All participants received one 50-minute Brief Motivational Intervention (based on the BASICS (link to write-up) program, and were then individually randomized to receive the behavioral economic supplement (SFAS; n = 41) or a control treatment (relaxation training; n = 41). Self-reported alcohol use, problems related to alcohol use, reinforcement of substance-free activities, depression, consideration of future consequences, protective behavioral strategies, and evening activity participation were collected before the first session (baseline), and at 1 and 6-month follow-ups. Seventy-one participants completed all three assessments for a follow-up rate of 87 percent.

Results: While students in both the treatment and control group experienced reductions in drinking and heavy drinking, the behavioral economic supplement had a significantly larger impact on reduction of alcohol-related problems at both the short and long-term follow-ups compared with the relaxation training. Marginal impacts were found for consideration of future consequences and protective behavioral strategies. No impacts were found for depression or substance-free reinforcement. For those who indicated higher depression at baseline, the behavioral economic supplement had a significantly larger impact on their long term reduction of heavy drinking. For those with low substance-free activity reinforcement at baseline, the behavioral economic supplement had a significantly larger impact on their short-term reduction of heavy drinking.